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Prevalence and Consequences of Preoperative Weight Loss in Gynecologic Surgery

1
Department of Gynecology, Department “Femme-Mère-Enfant”, Lausanne University Hospital, 1011 Lausanne, Switzerland
2
Department of Visceral Surgery, Lausanne University Hospital, 1011 Lausanne, Switzerland
*
Author to whom correspondence should be addressed.
Shared first authorship.
Nutrients 2019, 11(5), 1094; https://doi.org/10.3390/nu11051094 (registering DOI)
Received: 30 April 2019 / Revised: 12 May 2019 / Accepted: 14 May 2019 / Published: 17 May 2019
(This article belongs to the Special Issue Surgical Nutrition)
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Abstract

Preoperative malnutrition and weight loss negatively impact postoperative outcomes in various surgical fields. However, for gynecologic surgery, evidence is still scarce, especially if surgery is performed within enhanced recovery after surgery (ERAS) pathways. This study aimed to assess the prevalence and impact of preoperative weight loss in patients undergoing major gynecologic procedures within a standardized ERAS pathway between October 2013 and January 2017. Out of 339 consecutive patients, 33 (10%) presented significant unintentional preoperative weight loss of more than 5% during the 6 months preceding surgery. These patients were less compliant to the ERAS protocol (>70% of all items: 70% vs. 94%, p < 0.001) presented more postoperative overall complications (15/33 (45%) vs. 69/306 (22.5%), p = 0.009), and had an increased length of hospital stay (5 ± 4 days vs. 3 ± 2 days, p = 0.011). While patients experiencing weight loss underwent more extensive surgical procedures, after multivariate analysis, weight loss ≥5% was retained as an independent risk factor for postoperative complications (OR 2.44; 95% CI 1.00–5.95), and after considering several surrogates for extensive surgery including significant blood loss (OR 2.23; 95% CI 1.15–4.31) as confounders. The results of this study suggest that systematic nutritional screening in ERAS pathways should be implemented. View Full-Text
Keywords: enhanced recovery; weight loss; nutrition; surgery; gynecologic/oncology; gynecology; prehabilitation enhanced recovery; weight loss; nutrition; surgery; gynecologic/oncology; gynecology; prehabilitation
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Pache, B.; Grass, F.; Hübner, M.; Kefleyesus, A.; Mathevet, P.; Achtari, C. Prevalence and Consequences of Preoperative Weight Loss in Gynecologic Surgery. Nutrients 2019, 11, 1094.

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